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850532.pdfUSE PERMIT CITY OF EDMONDS ZONE # NUMDER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS Jt/ 1G `• NAME (OR NAME OF BUSINESS) d / !' i� �C'' ./ O %j s'S LEGAL DE RIPTION CHECK SUB IVIS ON NO. LID NO. MAILINGADDRESS--// U/Pc �(h CITY T ELEPHONE NUMBER 7 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. �d/w 7 5 Z EXISTING___ REOUIREDDEDICATION PROPOSED_.__ NAME 2 I" ke, /%U 1- 4 � SRIGHT OF WAYTREET USE PERMIT CONSTRUCTION EPERMIT REQUIRED LI rADDRESS �I ' G u / LI / I� �• / L SEE ENGINEERING MEMO DATED a CITY I� IELEPHGONE NUMB7ER SeG J( /T -7 D 3 Z L- J REMAR K� ADDRESS 7 /4/ Y ' .IL! C i / Z /_(. G_j 5 f METER SIZE UILDING SUPPLY SIZ( FIXTURE CITY TELEPHONE NUMBER 7,7L/ Z j REMARKS. .. _ .. STATE LICENSE NUMBER �L. 3 Z �l/ SIGN AREA ENV. REVIEW ALLOWED I PROPOSED COMPLETE I EXEMPT Least Description of Property -Include all easements Z OI VARIANCE OR CU * V—/ 9— -5— PLANNING flEVIEW BY DAT Z / / L t SS v/ y 3 v �'Y / ✓ L D$ /� ei 10%T s '7P 7 f/ REAfl HEtI Ip LOT COV E ' S G c 4, ea tom,., �.., NEW RESIDENTIAL El ADDIALTER COMMERCIAL REPAIR RETAINING WALL EXCAVATE OR FILL , FT) flEMARKSt f CHECKED BV TYPE OF CON TRUCTION _PREMOVE CODE HDEMOLISH INSPJSPECIAL REMODEL El COMPLIANCE INSP. WO INSERTVE/ APT.BLDG INSPECTOR EA OCCUPANCY OCCU REQUIRED GROUP A LOAD REMARKS 1.; NO -r- NUMBER OF STORIES moen y •> OWtLLING it .....,... ... ,...e,. ... UNI o�nr of eu, -1 _ - PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: 1 Year- Provided Work Is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and successors In interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of whatever nature, arising directly or Indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT modify,,walve or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." hereby acknowledge that I have read this application; that the Information given Is correct; and that I am the owner, or the duly ATTENTION authorized agent of the owner. I agree to comply with city and THIS PERMIT state laws regulating construction; and In doing the work authoriz- AUTHORIZES ed thereby, no person will be employed in violation of the Labor ONLY THE Code of the State of Washington relating to Workmen's Compensa• WORK NOTED ti_onInsurance. INSPECTION SIGNATURE WNER OR AGENT DATE SIGNED DEPARTMENT CITY OF —27J> EDMOND 771.n9n7 ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. 10278 T/i / "'I" APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Deputy; and fees are paid, and receipt is acknowledged In space provided. 'FICI L' I URE - DATE LEASED GATE cs _IZ RIGINAI — File Y LLO — Inspector PINK — Owner GOLD — Assessor ................. 1 � t I � I ( 1, :. 15+ '� ` (1' ;k...��1, V i/ �. •),1��� �C(?� rQ� �J\ , I f �1 (1r�4 t Ti ^ //,. t'J /i /!-j• / / , •'I 1 I . p ''� to I I� I © '�` �' � '��/ i � �' :,I:�-i7.•v I it 1 � __ �� to _' S t;} �•, i� ..rt r• • t :' i " , , qiW-1 ..` ; J `,, {� �� i ;f`S , '� Flo, • � .� � " J " TV • � I� I\ � li II � � jam,_ �}1'' ��,, �vL^��(�' i'C.7, i; Ali